Tuesday, November 13, 2018

Retelling a Story

Humans are innate story tellers. From oral histories that are shared around a community campfire to stories on television, in print, on social media and other internet platforms, we continue this tradition.

My mother wrote an autobiography a couple of years before she died. She worked diligently on it but did not collaborate with the rest of the family as she recorded the highlights of her life. When the book was published, there was a reaction of disbelief and shock from myself and some of my brothers as in several instances, the story she told was not the story we remembered. One of my brothers was indifferent to our protests and commented that it was Mom’s story and that is how she saw her life.

I agreed to press coverage of my recent hip replacement as it was the first, same day discharge for the hospital. I received a page of questions for the initial press release which I completed and emailed to the press officer. She sent the draft story to me and I was surprised by the focus of the article as well as the way my words were misquoted. I kept a copy of the answers that I submitted and challenged the author on her interpretation of what was said. We did come to a consensus and the published story was adequate but superficial and told in a voice other than my own.

Last week my surgeon and I were interviewed by the local CTV television station. The reporter was very professional and put us at ease. The recorded interviews likely totalled 7 to 10 minutes and the surgeon’s comments were particularly articulate and insightful. When the story was featured on the six o’clock news, the entire segment, including the reporter’s comments was three minutes long. The story was accurate but bare-boned and, in my opinion, the best of my surgeon’s comments were edited out.

After my mom’s book was published, a brother said he would never read any biography or autobiography in the same way again. My recent interactions with the press remind me that a video news clip, newspaper article or 280 character tweet will never capture the whole story but is written for the target audience. The emotional side of a story is more compelling more than a factual, objective version.

I was taught to believe that the Bible was the inerrant word of God with every detail accurate and factual because men were inspired to write under divine direction. Most scriptures began as oral traditions retold over centuries to cultures very different from our first world cultures today. The gospels were written decades after the events they describe and are contradictory at times. Story retelling in scripture reflected the authors' memories and the message they wished to relay to their specific audience. We deceive ourselves if we believe otherwise. 

What can we believe? Is my mother’s book or any other biography deceptive? Was the reporting on my surgery accurate and honest? Is the Bible true? What about the news we read and see every day?

My favourite section of the newspaper is the editorial page. I enjoy reading thoughtful analyses of news stories. I seek these types of articles online as well. A well written editorial, while an opinion piece, will discuss various perspectives and provide insight into complex topics. I try to read news from the least biased sites while avoiding memes and click bait on social media. 

Story telling is an art and will always contain biases. That is not a problem as long as we recognize the context of what we see and hear and understand the story teller’s objective for their target audience.

Here is a link to the news clip about my surgery. The story written in my voice is quite different in focus and detail. 

Sunday, November 11, 2018

1918-2018 Lest We Forget

My grandparents lived through two world wars. My paternal grandfather turned 14 in 1918. He came to Canada from Amsterdam in the early 1920’s as a young man. Several members of his extended family died as civilians during the world wars in Europe.

My maternal grandparents attended medical school at the University of Toronto during World War 1 in the graduating class of 1918. Grandma graduated as a doctor in 1918 but my grandfather graduated in 1919 because he served in the medical reserves for a year.

My husband’s father was born in August 1918. The Spanish Flu hit his community hard in October and November of the same year and hundreds of people in the region died, many of them young and previously healthy. This plague at the end of the war killed millions world wide as soldiers returned home from Europe.

I heard my family’s stories first hand as I was growing up. The suffering and sacrifices endured by that generation became very real and personal to me unlike other wars I learned about in text books at school. All I remembered about historical conflicts were the dates that we regurgitated on exam papers. 

The living connections to the world wars of the 20th century will soon be gone. Will the children of today and tomorrow remember these wars only as boring history lessons? 

Why do we not learn from the past? We quickly forget how extreme nationalism, racism, economic disparity, greed and unresolved historical grievances caused unprecedented loss of life. 

Sadly I realize that history is repeating itself again. The cycle never ends. There are people who remember and recognize the warning signs. Their voices are often drowned out by leaders and their followers who stoke fear and live without a vision for a peaceful future.

I heard the church bells toll 100 times today at sunset. I hope that the children who heard them ring this evening will learn, understand and commit to pathways of peace.

Bells of Peace -November 11, 2018 in Cambridge ON

Monday, November 05, 2018

A Visit to the 9/11 Memorial

We enjoyed a 5 day vacation in New York City this August. I booked the trip mainly because I wanted to see Come From Away on Broadway and that was a memorable highlight of the trip. I went to NYC with our daughters in 2008 and while some things were little changed, we explored several areas that were new to us. A city this big is impossible to cover in a few days

We spent a morning in the area of the 9/11 Memorial and Museum. The design of the museum, grounds and the adjacent Oculus centre is beautiful and highly symbolic. I saw several visitors expressing raw grief and I wondered at their loss and connection to the site. There were thousands of messages incorporated in the exhibits and they spoke of love, courage, sacrifice, forgiveness, and resilience. The best of human behaviour often shines in times of great loss and one could not help but be moved by the stories that were featured. America appears as a divided, unhinged country from my view in Canada, but we talked with many rational and thoughtful people in Manhattan who do not mirror their leader in attitude or behaviour. 

I will watch the midterm election results with interest tomorrow but whatever the outcome, I will remember with hope the good will that was represented at the memorial. We tend to forget the past so quickly. 

Here are a few pictures of the area. I would highly recommend taking the time to visit New York City. We went on a bus tour that offered some scheduled events as well as daily drop offs in the city which gave us plenty of free time to explore on our own. There were school-aged children in our group and I commend their parents for giving them a good introduction to the city.

Large fountains mark the foundations of the original twin towers. The names of the victims of the attack are inscribed here.

The Survivor Tree, replanted outside the 9/11 memorial, speaks of resilience in the face of adversity. I am carrying a Love is Stronger than Hate tote bag purchased at the museum.

The Oculus houses a transportation hub and the Westfield mall. Tour guides were available to explain the symbolism of the interesting building. 

The windows of the Oculus frame the new WTC tower. The light on the floor shines where the original building fell.

Friday, November 02, 2018

My Day Zero Discharge Post Hip Replacement

I went on a wait list for an elective total hip replacement in October 2017. I had nagging pain in my right hip for about three years and was surprised at the amount of damage shown on X-rays. I was still active and working full time but my surgeon warned me that hip degeneration can progress quickly. I completed a few weeks of physiotherapy treatment in the summer and then reluctantly went on the surgical wait list knowing my turn would not come up for a year.

By April 2018 the hip pain was interfering with my daily activities and sleep. I rapidly lost range of motion in spite of regular exercise and biking and work became more of a challenge. In July 2018 I received a surgical date for September 28, 2018. I arranged for a six month leave of absence starting in mid-September and began counting down the days until the procedure. I continued to exercise as much as possible but my ability to walk recreationally was limited. My routine was work, mat exercises, biking in the evening and then a restless sleep.

On September 27, 2018, I received a phone call from the hospital stating that my surgery the next day was cancelled due to bed shortages. I was devastated! I had discontinued my anti-inflammatory medication a few days before and was in a lot of pain. A new surgical date of October 16 was assigned but it was possible that surgery could be cancelled again. 

A week before the rebooked surgery, I was contacted by a hospital manager who asked if I would be interested in being the first patient at this hospital to try a same day discharge following hip replacement surgery. I knew this was a new initiative at some Toronto hospitals and was eager to be the test patient locally. After a couple of days, the surgical team agreed that I would be a good candidate for a Day #0 discharge and was informally assured that my surgery would not be cancelled again.

A few procedural changes were implemented to make the day a success. My spinal anaesthetic did not contain morphine and I was given a couple of IV boluses to help maintain my blood pressure during early mobilization after surgery. Preoperatively, my nurse calmed me with warm blankets and a reassuring approach rather than using Ativan. I was given the option of being conscious during surgery but left the decision to the surgical team and was sedated. 

Daily walks on my street are now up to 400 m
My surgery was at 8 AM and at 9:30 AM I was awake in the recovery room. Within 30 minutes I was able to move my feet and was transferred to the surgical unit. I walked to the bathroom with supervision at 11 AM and had lunch at noon. So far things were going exceptionally well and I was very confident! In the early afternoon I went up and down a flight of stairs with crutches and took a couple more walks in the room and hallway with a walker. Later in the afternoon I had an episode of low blood pressure while sitting up in a chair but recovered quickly after the nurse helped me back to bed. This is a common but alarming postoperative event that can lead to fainting and falls but it was good to bring my over confidence down a few notches.

I was discharged home at 6 PM and transferred easily into the car with my husband’s help. At home, I had the best sleep in months. My surgeon phoned in the evening to see how I was doing and I had calls from the surgical nurse practitioner the next two days. A home care physiotherapist visited the next morning. 

I am now 17 days post op and am making daily gains in strength and function. The first week had its ups and downs with pain control, but I had support from the surgical team at the hospital and my RN daughter who travelled from Ottawa to be with me for a few days. I am grateful to all my family for being available to me 24 hours a day at first and would not have been successful without them.

I have been a physiotherapist in this community since the mid-1970s and have seen literally thousands of post-operative hip patients, particularly when I worked in the home care sector. Early in my career, patients stayed in hospital for two weeks and went home after their incision healed. They spent the one week on the surgical floor and the second week on the rehab unit. Length of hospital stay for elective hip and knee surgery shortened over time to one week, five days and then one to three days as surgical techniques improved.

My knowledge and experience as a physiotherapist was very helpful of course, but being a joint replacement patient and dealing with pain and medication side effects first hand was a new experience. I am not keen on doing exercises that hurt and need to be encouraged like anyone else. I am attending a physiotherapy clinic as an outpatient because I can not assess myself objectively. I cannot drive for another month and require several months of healing and rehab to achieve my maximum potential. My goal is to return to work.

Wait times for joint replacement surgery have increased significantly in the last year in south-western Ontario and people are now waiting up to 20 months for elective orthopaedic procedures at some hospitals in this region. (Other hospitals in Ontario have much shorter wait times and this information is available online from the Ministry of Health.) My cohorts in the baby boomer generation will increase the numbers of people waiting for joint replacements for many more years. Earlier discharge from hospital after surgery allows for improved bed flow and potentially more surgeries could be accommodated. 

Good preoperative preparation is very important. I attended two clinics before surgery. At the first one a physiotherapist reviewed the equipment I needed and went over my exercises. The second was a medical assessment and teaching with the nurse, pharmacist and anaesthesiologist. It is important to have the right equipment set up at home and to understand your medications before surgery.

I had a followup appointment at the hospital yesterday and am doing very well. I am grateful to an excellent surgeon, the entire surgical team, community partners and my family for making this Day #0 discharge a success! 

Thursday, November 01, 2018


18 months….
  • the age difference between me and my eldest brother
  • 1/42 of my life in years
  • time enough to welcome a beautiful granddaughter who will be 1 year old this month
  • a time of waiting for elective orthopaedic surgery
  • the length of time that has elapsed since adding a post to this blog

June 2017 was the month I had medical investigations that eventually landed me on a wait list for a total hip replacement. I had the surgery 16 days ago. In Canada's publicly funded health care system people often wait for elective surgical procedures. (It is good to know that urgent medical conditions receive more timely treatment) I was able to function well enough in this period of time to keep working and enjoy family as well as some vacation time this summer. Walking became increasingly painful and it was most comfortable to ride my bike for exercise. I missed birding and trail walking this year. 

This is a season of recovery and I have much to be thankful for. My surgeon told me that hip replacement and cataract surgery are two procedures that add the most quality of life to recipients. In a past generation I would be using a cane and a rocking chair for the rest of my days. 

I have been keeping a hand written journal over the past few years but want to share some thoughts on how life has been evolving lately. Change is challenging but resistance to change stems from an inflexible attitude that hinders new learning. Critical thinking, questioning, contemplating history, and being open to new ideas should not stop at any stage of life. 

And I have the time right now for reflection!